Last RUOP Journal

Journal 8 – July 8, 2006

It’s good to be back. Although leaving the clinic was pretty tough. I really felt like I belonged there, at least in the clinic, not necessarily the town. They even had a going away potluck and bought me a gift.

The kind of medicine practiced there is exactly what I’d like to do. The bonds formed between the physician and his patients make it a highly rewarding experience. The doctors and staff don’t seem to mind putting in the extra time and effort that it takes. There seems to be a higher level of commitment to their patients, probably because they’re related to, or at least friends with, most of them. I didn’t see this level of care at Group Health.

So am I getting ready to pack everything up and move to Cathlamet? Not quite. I was getting pretty tired of the area. It doesn’t have much to offer in the way of activities and there’s little diversity to speak of. Toward the end I started to spend more time with the ex-hippies out in Skamokawa. But the people of Cathlamet are wonderful. Maybe a bit conservative but refreshingly unpretentious.

So the big question is, can I find a place where this kind of medicine is practiced but still enjoy some of the life that a place like Seattle has to offer? Well, I still have three years to figure that out.

Last words of wisdom: If you’re ever in Cathlamet stop by Janet’s and get the Dungeness Crab and White Cheddar Omelet. That’s about all I have.

Journal 7

Journal 7 – July 5, 2006

I’m starting to get to know some of these people pretty well, or at least parts of them. Like MW’s knee which I’ve pumped full of Synvisc twice now or SG’s gouty toe. Funny, I don’t always remember names but I can remember problems. I bumped into a patient in the lounge one evening and again in the grocery store the next day. We had good, long conversations but I just couldn’t pull his name up from my memory. All I could remember was that he survived bladder cancer and has a stoma. Just running out of space I guess. I don’t know how I’m going to squeeze another year of classes in there.

We had a great 4^th of July here. Thankfully, nobody got hurt. The pager didn’t go off once. It gave us plenty of time to stuff ourselves full of burgers and ice cream and then blow a bunch of stuff up. Dr. Wright is a completely different person around a bag full of fireworks. The only bad part about last night was getting up at 5 this morning to go do rounds.

Kayaking in Skamokawa

The town of Skamokawa














Steamboat Slough





















more Steamboat Slough

















Skamokawa Creek outlet to the Columbia River

Journal 6

Journal 6 – June 30, 2006

It seems like they saved up the unusual cases just for my visit. I was expecting 4 weeks of otitis media and diabetes care. Now I can add transverse myelitis to the list. One of our patients is in the hospital right now paralyzed from the neck down with no apparent cause. The plan was to do an LP on Thursday to find out what happened but, the time I left on Friday, it still hadn’t been done. We thought the neurologist planned on doing it at noon on Thursday but found late that afternoon that he hadn’t even visited the patient (that he early said was the most serious neurology case in the hospital). When someone was finally able to get in contact with them he stated that the neurology department doesn’t do LPs and it would have to be done in radiology under fluoroscopy. Radiology said they couldn’t do it because they were going home. As if things weren’t bad enough for this lady. Being bounced around within the bureaucracy had to be frustrating.

Little obstacles like this seem to be quite common in Peace Health. I’m beginning to wonder if it’s the same in all large healthcare organizations. Is this my future?

Last note for the day: ambulances and people who get motion sickness don’t mix!